体象 弦如琴弦，轻虚而滑；端直以长，指下挺然。
弦之为义，如琴弦之挺直而略带长也。弦脉与长脉皆主春令，但弦为初春之象，阳中之阴，天气犹寒，
故如琴弦之端直，而挺然稍带一分之紧急也。长为暮春之象，纯属于阳，绝无寒意，故如木干之迢直
以长，纯是发生气象也。
主病 弦为肝风，主痛主疟，主痰主饮。左寸弦者，头痛心劳。弦在左关，痰疟 瘕。左尺得弦，
饮在下焦。右寸弦者，胸及头疼。弦在右关，胃寒膈痛。右尺得弦，足挛疝痛。
胆为甲木，肝为乙木。自北而东，在肝为厥阴而阴尽，在胆为少阳而阳微。初春之象，逗气尚少，升如一
缕，有弦义焉。风属木而应春，弦是其本脉，生于风则象风，故脉自弦。弦寒敛束，气不舒畅，故又主痛疟
之作也。邪正交争，或寒而热，热而寒，寒热往来，正邪出入，枢主于中。《素问·阴阳离合论》曰∶“少阳
为枢”，故脉亦当弦。饮者，痰之类也。弦直而敛，无鼓荡之力，故饮留焉。头乃六阳所聚，阳虚不能张大，
或致外邪所乘，安得不痛。疟疾寒热往来，常在少阳经，故曰“疟脉自弦”，又曰“无痰不成疟”。 瘕处
于其地，则邪正不敌，小腹沉阴之位，受寒乃痛。肺家阳气衰微，更受阴寒，或右边头痛，或胸次作疼。木
来乘土，胃寒不化，真火不足，无以温暖肝木，挛痛之自来也。
兼脉 浮弦支饮，沉弦悬饮。弦数多热，弦迟多寒。阳弦头疼，阴弦腹痛。单弦饮癖，双弦寒痼。
饮停在上不在胃，而支留于心胸；饮停在下不在胃，而悬留于腹胁。故一弦而浮，一弦而沉也。数则为
热，弦而兼数者，病亦兼热。迟则为寒，弦而兼迟者，病亦兼寒。阳弦者，寸弦也。邪在三阳，三阳走头，故头
疼。阴弦者，尺弦也。邪在三阴，三阴走腹，故腹痛。单弦则止为饮癖。若脉见双弦，已具纯阴之象，若不能
食，为木来克土，必不可治。
按弦脉在八卦为震，在五行为木，在四时为春，在五脏为肝。《素问·玉机真藏论》曰∶“春脉，肝也，东
方木也，万物之所以始生也。故其气来软弱，轻虚而滑，端直以长，故曰弦。反此者病。其气来而实强，此
为太过，病在外；其气来不实而微，此为不及，病在中。太过则令人善怒，忽忽眩冒而巅疾；不及则令人
胸胁痛引背，两胁 满。”《素问·平人气象论》曰∶“平肝脉来，软弱招招，如揭长竿末梢，曰肝平。春以
胃气为本。病肝脉来，盈实而滑，如循长竿，曰肝病。死肝脉来，急益劲，如新张弓弦，曰肝死。”戴同父云∶
“弦而软，其病轻。弦而硬，其病重。”深契《内经》之旨。《素问·玉机真藏论》云∶“端直以长。”叔和云∶
“如张弓弦。”巢氏云∶“按之不移，察察如按琴瑟弦。”戴同父云∶“从中直过，挺然指下。”诸家之论弦脉，
可谓深切着明。而伪诀乃言“时时带数”，又言“脉紧状绳牵”，则是紧脉之象，安在其弦脉之义哉！弦
亦谓其主痰。然以饮较痰尚未结聚，所以弦不似滑之累累替替之有物形也。
【体象】
弦脉的形态如同琴弦，轻按感觉虚软而滑利；脉形端直且长，手指下感觉挺拔有力。
弦脉的含义，就像琴弦那样挺直且略带长度。弦脉与长脉都主春季的时令，但弦脉是初春的景象，属于阳中之阴，天气仍然寒冷，所以像琴弦一样端直，在指下挺拔并稍带一分紧急感。长脉是暮春的景象，完全属于阳，完全没有寒意，所以像树木的主干那样遥远笔直且长，完全是生机勃发的景象。
【主病】
弦脉对应肝风，主痛证、疟疾、痰饮。左寸部出现弦脉，主头痛和心劳（心神劳损）。弦脉出现在左关部，主痰饮、疟疾及瘕积（腹内结块）。左尺部出现弦脉，主水饮停留于下焦。右寸部出现弦脉，主胸部和头部疼痛。弦脉出现在右关部，主胃寒和膈部疼痛。右尺部出现弦脉，主足部痉挛和疝气疼痛。
胆属甲木，肝属乙木。从北方到东方，在肝脏表现为厥阴经，阴气尽；在胆腑表现为少阳经，阳气微弱。初春的景象，阳气萌动尚少，升发如一丝细线，具有弦脉的意义。风属木而应合春季，弦脉是其本脉，因风而生则呈现风的象，所以脉自呈弦象。弦脉带有寒性，收敛束缚，气机不舒畅，所以又主痛证和疟疾的发生。邪气与正气交争，或先寒后热，或先热后寒，寒热往来，正气与邪气出入，枢机主持于中。《素问·阴阳离合论》说：“少阳为枢”，所以脉象也应当呈弦象。饮，是痰的一类。弦脉直而收敛，没有鼓荡之力，所以水饮停留。头部是六阳经汇聚之处，阳气虚弱不能张大，或者导致外邪侵袭，怎么能不痛呢？疟疾寒热往来，常在少阳经发生，所以说“疟脉自弦”，又说“无痰不成疟”。瘕积处于其部位，则邪正不敌，小腹是沉阴之位，受寒就会疼痛。肺家阳气衰微，再受阴寒侵袭，或者右边头痛，或者胸中作痛。木来乘土（肝木克脾土），胃寒不能消化，真火不足，无法温暖肝木，痉挛疼痛自然而来。
【兼脉】
浮弦脉主支饮，沉弦脉主悬饮。弦数脉多热，弦迟脉多寒。阳弦（寸脉弦）主头疼，阴弦（尺脉弦）主腹痛。单弦脉主饮癖，双弦脉主寒痼（顽固性寒疾）。
水饮停在上部不在胃，而是支留于心胸；水饮停在下部不在胃，而是悬留于腹胁。所以一个呈弦而浮，一个呈弦而沉。数脉则为热，弦脉兼见数脉，病也兼有热。迟脉则为寒，弦脉兼见迟脉，病也兼有寒。阳弦，是指寸脉弦。邪在三阳经，三阳经上行头部，所以头疼。阴弦，是指尺脉弦。邪在三阴经，三阴经下行腹部，所以腹痛。单弦脉只是表现为饮癖。如果脉见双弦，已经具备纯阴之象，如果不能进食，这是木来克土，必定不可治。
【按语】
弦脉在八卦中属震卦，在五行中属木，在四时中属春，在五脏中属肝。《素问·玉机真藏论》说：“春脉，对应肝，也是东方木，是万物开始生长的原因。所以它的脉气来时软弱，轻虚而滑，端直以长，所以叫弦。与此相反的就是病。脉气来时实强，这是太过，病在外；脉气来时不实而微弱，这是不及，病在中。太过则使人容易发怒，恍惚眩晕冒昧而发生巅顶疾病；不及则使人胸胁痛牵引背部，两胁胀满。”《素问·平人气象论》说：“正常的肝脉来时，软弱招招，像举起长竿的末梢，叫做肝平。春季以胃气为本。病的肝脉来时，盈实而滑，像抚摸长竿，叫做肝病。死的肝脉来时，急迫强劲，像新拉开的弓弦，叫做肝死。”戴同父说：“弦而软，病轻。弦而硬，病重。”这深深契合《内经》的宗旨。《素问·玉机真藏论》说：“端直以长。”叔和说：“像张开的弓弦。”巢氏说：“按之不移，察察如按琴瑟弦。”戴同父说：“从中直过，挺然指下。”诸家对弦脉的论述，可以说是深切着明。然而伪诀却说“时时带数”，又说“脉紧状绳牵”，这是紧脉的象，哪里还有弦脉的意义呢！弦脉也说它主痰。然而与水饮相比，痰尚未结聚，所以弦脉不像滑脉那样累累替替地有物形。
[Body Image]
The morphology of the Xian (String-like) pulse is like a lute string; lightly pressed, it feels empty and slippery. The pulse shape is straight and long, feeling upright and firm under the fingers.
The meaning of the Xian pulse is like the straightness and slight length of a lute string. Both the Xian pulse and the Chang (Long) pulse govern the spring season. However, the Xian pulse represents early spring, which is Yin within Yang; the weather is still cold, so it resembles the straightness of a lute string, feeling upright with a slight sense of tension under the fingers. The Chang pulse represents late spring, belonging purely to Yang, without any cold sensation, resembling the distant straightness and length of a tree trunk, embodying pure generative energy.
[Main Diseases]
The Xian pulse corresponds to Liver Wind, governing pain syndromes, malaria, phlegm, and fluid retention. A Xian pulse at the Left Cun position indicates headache and Heart exhaustion (mental fatigue). A Xian pulse at the Left Guan position indicates phlegm-fluid, malaria, and Jia masses (abdominal masses). A Xian pulse at the Left Chi position indicates fluid retention in the Lower Jiao. A Xian pulse at the Right Cun position indicates chest and head pain. A Xian pulse at the Right Guan position indicates Stomach cold and diaphragmatic pain. A Xian pulse at the Right Chi position indicates foot spasms and hernia pain.
The Gallbladder belongs to Jia Wood, and the Liver belongs to Yi Wood. Moving from North to East, in the Liver it manifests as the Jueyin channel where Yin is exhausted, and in the Gallbladder it manifests as the Shaoyang channel where Yang is weak. The image of early spring shows that Qi is just beginning to rise, like a single thread, possessing the meaning of the Xian pulse. Wind belongs to Wood and corresponds to Spring; the Xian pulse is its fundamental pulse. Generated by wind, it presents the image of wind, hence the pulse naturally becomes Xian. The Xian pulse carries cold and constricts, causing Qi mechanism to be unsmooth, thus also governing the occurrence of pain and malaria. When pathogenic factors and righteous Qi contend, alternating between cold and heat, or heat and cold, with alternating chills and fever, and the interplay of righteous and pathogenic factors, the pivot is governed in the middle. The *Suwen: Yin-Yang Lihe Lun* states: "Shaoyang serves as the pivot," therefore the pulse should also be Xian. Fluid retention is a type of phlegm. The Xian pulse is straight and constrictive, lacking the power of agitation, thus allowing fluid retention to remain. The head is the gathering place of the Six Yang channels; if Yang Qi is deficient and cannot expand, or if external pathogens invade, how can there be no pain? Malaria with alternating chills and fever often occurs in the Shaoyang channel, hence it is said that "the malaria pulse is naturally Xian," and also "no phlegm, no malaria." When Jia masses are located in their area, pathogenic and righteous factors are unequal; the lower abdomen is a position of deep Yin, and pain arises upon receiving cold. If Lung Yang Qi is weak and further affected by Yin cold, it may cause right-sided headache or chest pain. Wood overacting on Earth (Liver Wood attacking Spleen/Stomach), Stomach cold failing to digest, insufficient True Fire unable to warm Liver Wood, leads naturally to spasmodic pain.
[Combined Pulses]
Floating Xian indicates Zhi fluid retention; Sunken Xian indicates Xuan fluid retention. Xian-Shu (Rapid) indicates much heat; Xian-Chi (Slow) indicates much cold. Yang Xian (Cun Xian) indicates headache; Yin Xian (Chi Xian) indicates abdominal pain. Single Xian indicates fluid accumulation; Double Xian indicates chronic cold conditions.
Fluid retention stopping above but not in the Stomach branches and remains in the Heart and Chest; fluid retention stopping below but not in the Stomach hangs and remains in the Abdomen and Flanks. Hence, one is Xian and floating, the other is Xian and sunken. Shu indicates heat; when Xian combines with Shu, the disease also involves heat. Chi indicates cold; when Xian combines with Chi, the disease also involves cold. Yang Xian refers to the Xian pulse at the Cun position. Pathogens in the Three Yang channels travel to the head, hence headache. Yin Xian refers to the Xian pulse at the Chi position. Pathogens in the Three Yin channels travel to the abdomen, hence abdominal pain. Single Xian merely indicates fluid accumulation. If the pulse appears Double Xian, it already possesses the image of pure Yin; if accompanied by inability to eat, this is Wood overcoming Earth, and it is definitely incurable.
[Commentary]
In the Eight Trigrams, the Xian pulse belongs to Zhen; in the Five Elements, it belongs to Wood; in the Four Seasons, it belongs to Spring; in the Five Zang Organs, it belongs to the Liver. The *Suwen: Yuji Zhenzang Lun* states: "Spring pulse corresponds to the Liver, which is Eastern Wood, the reason why all things begin to grow. Therefore, its Qi comes soft and weak, light, empty, and slippery, straight and long, hence called Xian. Opposite to this is disease. If the Qi comes solid and strong, this is Excess, and the disease is external; if the Qi comes insubstantial and faint, this is Deficiency, and the disease is internal. Excess causes irritability, sudden dizziness, vertigo, and diseases of the vertex; Deficiency causes chest and flank pain radiating to the back, and fullness in both flanks." The *Suwen: Pingren Qixiang Lun* states: "A normal Liver pulse comes soft and swaying, like holding the tip of a long pole, called Normal Liver. Spring relies on Stomach Qi as its foundation. A diseased Liver pulse comes full, solid, and slippery, like tracing a long pole, called Diseased Liver. A dying Liver pulse comes urgent and forceful, like a newly strung bowstring, called Dying Liver." Dai Tongfu said: "Xian and soft indicates mild disease; Xian and hard indicates severe disease." This deeply aligns with the principles of the *Neijing*. The *Suwen: Yuji Zhenzang Lun* says: "Straight and long." Hehu Chao (Sun Simiao's predecessor, often referred to as Huashan Tuozai or similar, here likely referring to Wang Shuhe/Golden Window author) said: "Like a drawn bowstring." Chao Yuanfang said: "Pressing does not move, crisp like pressing a lute string." Dai Tongfu said: "Passing straight through the middle, upright under the fingers." The discussions of various schools on the Xian pulse can be described as profound and clear. However, the spurious formula says "often accompanied by Shu (rapid)," and says "pulse tight like pulling a rope," which is the image of the Jin (Tight) pulse, where is the meaning of the Xian pulse? The Xian pulse is also said to govern phlegm. However, compared to fluid retention, phlegm has not yet condensed, so the Xian pulse does not resemble the rolling, bead-like form of the Hua (Slippery) pulse.